Awareness, attitude, and distribution of high blood pressure among health professionals

BP control is suboptimal Worldwide. Little is known about attitudes of health professionals toward their BP status. To estimate awareness, attitudes, and distribution of blood pressure among health professionals. Prospective cross-sectional survey. Study was conducted among health professionals in two tertiary hospitals in Riyadh, KSA during December 2010. Socio-demographics, risk factors for high BP, awareness, and adherence to treatment were recorded. Six hundred and seventy-two subjects, 66.6% females, mean age 36.2 + 13.9 years. Prevalence of Hypertension [HTN] was 28%. 114 [60.6%] patients had self reported HTN in HTN group while 74 [11%] of total study population, were not aware that they have HTN which was detected on screening. Stress and lack of formal exercise were prevalent risk factors for HTN, present in 44.1% and 36.1%, of patients, respectively, while obesity was present in 19.4%. Many participants were not aware of recently recommended target value of blood pressure. 22.3% patients were irregular for their follow-up. 12.2% patients were not adherent to the treatment. Isolated systolic hypertension was more common in men. A point of serious concern was that relatively young health professionals, who were not known to be hypertensive did not monitor their BP, found to have HTN. Suboptimal awareness and lack of adherence to the treatment for BP among health professionals is of serious concern, for increased chances of cardiovascular events. Physical exercise, correction of obesity and compliance with treatment may reduce the risk of HTN-related adverse outcome in this special subset of the population

Plasma fibrinogen and its correlates in adult Saudi population

To determine plasma fibrinogen and its correlates in the adult Saudi population and to investigate hyperfibrinogenemia as a possible risk factor for cardiovascular diseases [CVD]. A cross-sectional survey was designed and carried out through multi-stage stratified cluster random sampling of every third house in 6 heterogeneously populated districts of Riyadh, Kingdom of Saudi Arabia, during the period 1999 to 2002. Demographic and clinical data of 2263 adult Saudi subjects, consisting of 1934 [85.5%] men and 329 [14.5%] women, was collected through a standard questionnaire. Body mass index [BMI], blood pressure [BP] and history of smoking were recorded. Plasma fibrinogen, total serum cholesterol, triglycerides, high density lipoproteins [HDL] and blood sugar were determined in fasting blood samples. The majority [84.6%] of the subjects were between 20-50 years of age. The mean plasma fibrinogen was 336 +/- 115 mg/dl, and was increasing with age both in men and women. The mean +/- SD fibrinogen in women [357 +/- 118 mg/dl] was significantly higher [p value of 0.03] than men [332 +/- 114 mg/dl]. Hyperfibrinogenemia [>400 mg/dl] was indicated in 554 [24.6%] of the total subjects. Among hyperfibrinogenemic Saudi adults, the prevalence of hypercholesterolemia was 14.3%, hypertriglyceridemia 24%, obesity 26.3%, systolic/diastolic hypertension 11.5% and 11% and hyperglycemia 26% [in women only]. A reciprocal relation was observed between HDL and plasm fibrinogen. Significant positive correlation was seen between fibrinogen and BMI, systolic and diastolic BP and total cholesterol. There was no significant difference in the distribution of plasma fibrinogen between smokers and non-smokers [p value of 0.864]. The difference in the magnitude of metabolic as well as modifiable CVD risk factors between smokers and non-smokers was not significant, except serum triglyceride which was significantly higher in smokers than non-smokers [p value of 0.020]. A significant positive correlation was observed between hyperfibrinogenemia and obesity, systolic/diastolic hypertension and hypercholesterolemia. Our results thus support the earlier reports that hyperfibrinogenemia is a potential CVD risk factor. Unlike other reports, we could not find any correlation between smoking and plasma fibrinogen in our studied subjects. The value of hyperfibrinogenemia as a definite risk factor for CVD has to be quantified in future case-control studies comparing its significance between CVD subjects and normal controls

Hypercholesterolemia in healthy adult males- A public survey in central Saudi Arabia

To describe hypercholesterolemia in an urban community in Saudi Arabia, total serum cholesterol [TSC] was measured in 966 apparently healthy males [475 Saudi Arabs, 351 other Arabs and 140 non-Arabs] using a portable analyzer [Boehringer ModeU[R]]. Mean age was 35.9 years [SD +/- 9.1] and mean body mass index [BMI] was 26.2 kg/m[2] [SD +/- 3.4] with a mean TSC of 5.20 mmol [SD +/- 1.21]. Mean TSC was significantly higher among non-Arabs at 5.74 mmol/L [SD +/- 1.48] than in Saudi Arabs at 4.93 mmol/L [SD +/- 1.11], P<0.001 mmol/L. TSC was higher than 5.20 mmol/L in 44.3% and higher than 6.80 mmol/L in 6.9% of the population. TSC was higher than 6.80 mmol/L in 3.6% of Saudi Arabs, 8.0% in other Arabs and 15.7% in the non-Arabs. This calls for cholesterol screening of the indigenous male population for hypercholesterolemia and other coronary heart disease risk factors at every opportunity. Among expatriate males, a mass screening strategy might be appropriate. The health care system needs appropriate adjustment to deal with this growing health problem

Does omentectomy affect ultrafiltration in peritoneal dialysis?

An animal model was studied to test the effect of omentectomy on Ultrafiltration. Two groups of white New Zealand female rabbits similar in age and weight were used. One group had omentectomy, the second control group had a sham operation. Peritoneal dialysis solution of 4.25% glucose, concentration [50 ml/kg] was infused into the peritoneal cavity through a Tenchkoff catheter. I[131], tagged albumin [RISA] was used to assess the intraperitoneal fluid volume. It was found that the intraperitoneal volume in the omentectomy group increased from 118.6+ 11.2 ml to 182.3+24.4 ml while in the controls it increased from 118.3+7.2 to 168.3+ 18.2 ml. The difference was statistically significant [p<0.025]. Glucose absorption from the dialysis fluid was less in the omentectomy group than that of the control group but it did not affect either the dialysate osmolality or the serum osmolalrty in both groups. This suggests that omentectomy causes an increased Ultrafiltration and a possible- decreased reabsorption

Continuous ambulatory peritoneal dialysis in Saudi Arabia

This study describes the experience in King Khalid University Hospital, Riyadh, with continuous ambulatory peritoneal dialysis [CAPD]. Over a period of 28 months 24 patients were studied, 15 males and nine females with ages ranging from 13 to 70 years. The total period of CAPD was 238 patient-months. Peritonitis remains the major complication, occurring with an overall incidence of one episode every 10.35 patient-months. CAPD is a useful alternative therapy for end stage renal disease [ESRD] patients

Control of hyperoxaluria with large doses of pyridoxine in patients with kidney stones

Pyridoxine [250-500 mg, orally daily] was administered to 12 patients suffering from recurrent calcium oxalate renal calculi and idiopathic hyperoxaluria, with a resulting significant decrease [P< 0.025] in urinary oxalate excretion during up to 18 months of treatment, which was more marked in the initial 3 to 6 months. In that period, eight patients showed no evidence of active stone disease, three showed slight increase in the size old stone [s], and a new stone formed in one patient. None of these patients suffered any significant complications from the therapy. These findings show that pyridoxine in pharmacologic doses is useful in the management of elevated urinary oxalate excretion in patients with recurrent oxalate renal calculi